Comparison of clinical characteristics and outcomes of critically ill adults with SARS-CoV-2 infection during Delta and Omicron variant predominance periods: a single-hospital retrospective cohort study.
Comparison of clinical characteristics and outcomes of critically ill adults with SARS-CoV-2 infection during Delta and Omicron variant predominance periods: a single-hospital retrospective cohort study.
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Delta 和 Omicron 变异优势期 SARS-CoV-2 感染危重成人的临床特征和结果比较：单医院回顾性队列研究。
DOI：
10.1136/bmjresp-2022-001274
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发表时间：
2023-02
影响因子：
4.1
通讯作者：
中科院分区：
文献类型：
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作者：
初步报告表明，与 B.1.617.2 (Delta) 变体相比，SARS-CoV-2 的 B.1.1.529 (Omicron) 变体引起的疾病较轻，但更广泛的疫苗接种促成了这些发现。对于 Delta 和 Omicron 变异占优势期间需要重症监护的 SARS-CoV-2 感染患者的临床特征和结果知之甚少。检查和比较 Delta 和 Omicron 变异占优势期间感染 SARS-CoV-2 的危重成人的特征。我们在 Delta（2021 年 7 月 15 日至 2021 年 9 月 23 日）和 Omicron（2021 年 12 月 21 日至 2022 年 1 月 27 日）占主导地位期间，对洛杉矶一家学术医院感染 SARS-CoV-2 的危重成人进行了回顾性队列研究。对 Delta 期和 Omicron 期住院患者的总体特征进行比较，并按疫苗接种状态进行分层。在 Delta 占主导地位期间，有 79 名成年人需要重症监护，在 Omicron 占主导地位期间，有 116 名成年人需要重症监护。我们发现，在这两个时期内，完全接种疫苗的患者入住重症监护室的比例相似，尽管洛杉矶县的数据显示，完全接种疫苗的患者因 SARS-CoV-2 住院的比例增加了近 60%。有创机械通气 (IMV) 的需求没有差异。在需要 IMV 的人群中，IMV 的中位持续时间总体较短（Delta=18 天；Omicron=8 天；p=0.006），而在未接种疫苗的人群中（Delta=19 天；Omicron=8.5 天；p=0.018）。在未接种疫苗的人中，在 Omicron 占主导地位期间，重症监护病房的中位住院时间较短（Delta = 12 天；Omicron = 5 天；p = 0.037）。住院期间死亡的患者比例没有差异。在这项单家医院研究中，感染 SARS-CoV-2 的危重患者在 Omicron 占主导地位期间经历了较轻的呼吸道疾病，这可能是由于变异特异性毒力降低。在 Omicron 占主导地位期间，疫苗接种可能会减少感染 SARS-CoV-2 的成年人危重疾病的发展。
Initial reports suggest the B.1.1.529 (Omicron) variant of SARS-CoV-2 causes less severe disease compared with the B.1.617.2 (Delta) variant, though more widespread vaccination contributed to these findings. Little is known about clinical characteristics and outcomes of patients with SARS-CoV-2 infection requiring intensive care during periods of Delta and Omicron variant predominance. To examine and compare characteristics of critically ill adults with SARS-CoV-2 infection during periods of Delta and Omicron variant predominance. We conducted a retrospective cohort study of critically ill adults with SARS-CoV-2 infection at one academic hospital in Los Angeles during Delta (15 July 2021–23 September 2021) and Omicron (21 December 2021–27 January 2022) predominance. Patient characteristics were compared between Delta-period and Omicron-period hospitalisations, overall and stratified by vaccination status. 79 adults required intensive care during the Delta predominance period and 116 during the Omicron predominance period. We found similar proportions of intensive care unit admissions occurring in fully vaccinated patients between the two periods, despite Los Angeles County data revealing an almost 60% increase in the proportion of SARS-CoV-2 hospitalisations occurring in fully vaccinated persons. There was no difference in the need for invasive mechanical ventilation (IMV). Among those who required IMV, the median duration of IMV was shorter overall (Delta=18 days; Omicron=8 days; p=0.006) and among unvaccinated persons (Delta=19 days; Omicron=8.5 days; p=0.018). Among unvaccinated persons, the median intensive care unit length of stay was shorter (Delta=12 days; Omicron=5 days; p=0.037) during Omicron predominance. There was no difference in the proportion of patients who died while hospitalised. In this single-hospital study, critically ill patients with SARS-CoV-2 infection experienced less severe respiratory disease during Omicron predominance, likely due to reduced variant-specific virulence. Vaccination likely reduced development of critical illness in adults with SARS-CoV-2 infection during Omicron predominance.
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DOI：
10.15585/mmwr.mm7104e4
发表时间：
2022-01-28
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
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作者：
通讯作者：
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在B.1.617.2（Delta）和B.1.1.529（Omicron）变体占主导地位时，在实验室确认的SARS-COV-2感染的成年人中的临床特征和结果，2021年，以及2021年12月21日至2022年1月27日。
DOI：
10.15585/mmwr.mm7106e2
发表时间：
2022-02-11
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Modes ME;Directo MP;Melgar M;Johnson LR;Yang H;Chaudhary P;Bartolini S;Kho N;Noble PW;Isonaka S;Chen P
通讯作者：
Chen P
影响因子：
33.9
作者：
Danza, Phoebe;Koo, Tae Hee;Balter, Sharon
通讯作者：
Balter, Sharon
影响因子：
64.8
作者：
Hui, Kenrie P. Y.;Ho, John C. W.;Chan, Michael C. W.
通讯作者：
Chan, Michael C. W.
影响因子：
64.8
作者：
Halfmann PJ;Iida S;Iwatsuki-Horimoto K;Maemura T;Kiso M;Scheaffer SM;Darling TL;Joshi A;Loeber S;Singh G;Foster SL;Ying B;Case JB;Chong Z;Whitener B;Moliva J;Floyd K;Ujie M;Nakajima N;Ito M;Wright R;Uraki R;Warang P;Gagne M;Li R;Sakai-Tagawa Y;Liu Y;Larson D;Osorio JE;Hernandez-Ortiz JP;Henry AR;Ciuoderis K;Florek KR;Patel M;Odle A;Wong LR;Bateman AC;Wang Z;Edara VV;Chong Z;Franks J;Jeevan T;Fabrizio T;DeBeauchamp J;Kercher L;Seiler P;Gonzalez-Reiche AS;Sordillo EM;Chang LA;van Bakel H;Simon V;Consortium Mount Sinai Pathogen Surveillance (PSP) study group;Douek DC;Sullivan NJ;Thackray LB;Ueki H;Yamayoshi S;Imai M;Perlman S;Webby RJ;Seder RA;Suthar MS;García-Sastre A;Schotsaert M;Suzuki T;Boon ACM;Diamond MS;Kawaoka Y
通讯作者：
Kawaoka Y